Answers (1)

You are at the theraputic doseage for Effexor. Clinical trails showed no significant increase in benefit on doses greater than 225mg of Effexor, though it can be prescribed as high as 350mgs.

As far as the pain control, it is not a labelled treatment for pain. It may help your pain some, but generally not prescribed for that. An antidepressant that is prescribed for nerve pain is Cymbalta which acts on the same neurotransmitters that the Effexor works on, so they are similar in that regard.

Since you have fibromyalgia, I really recommend you ask your doctor about Cymbalta. It will help the nerve pain and the depression. I have taken Cymbalta for years and had good results for pain and depression. You would have to taper off the Effexor and start the Cymbalta, but should have no ill effects if done slowly and concurrently.

Great question!There are a lot of reasons and it involves lots of grey areas. I will give a few examples.1) Getting the most obvious and easiest out of the way if you had side effects or intolerance to one you could switch2) Depending on kidney and liver function you might want to choose one over the other. Both drugs are eliminated from the body and metabolized by both the organs but at differnet extents. They have different guidlines for when it should be stoped3) Effexor works very well in patients with concurrent anxiety. In fact, effexor is consider a go to option.4) You also have to consider which other medicines someone is on. Both medications are metabolized by 2D6 (an enzyme for breaking down chemicals) but cymbalta is also broken down by 1A2. Many other medications can decrease the ability of the enzyme to get rid of the cymbalta so you can get higher and dangerous levels of cymbalta.

Hi, ive just come across this post form a couple of years ago and am interested in anyones input. I have been on Effexor XR 600mg daily for about 12 yrs now (took about 6yrs of numerous other antidepressants and severe depression to get to it?) and have had relative success with it and a combination of other drugs along the way to help with down times??? I have been diagnosed with Lupus and Fibromyalgia about 8yrs ago and have numerous health issues related to it? However my psychiatrist of 18yrs retired a year ago and my new psychiatrist is younger and not comfortable with my dose of Effexor and says that I would be gaining NO additional benefit than if I was on 300mg.? I have come off my Effexor twice in the last 8yrs when pregnant for the duration of my pregnancies and life has been awful until I returned to the original dose of 600mg? Is it likely that there is any pharmacological basis for taking the 600 mg and WHY do I not get the benefit of a lower dose? is there any way of working out why I need the higher dose? Thanks in advance! Ta Fi

Not really, 600mg is almost double the recommended maximum which is based on clinical trial response to titrating the medication. No additional benefit was seen after the 350 max. Unlikely you are truly needing that much, but be sure to taper down slowly so to avoid withdrawal symptoms.

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